﻿<%@ Page Language="C#" AutoEventWireup="true" CodeBehind="SearchPassportProvider.aspx.cs"
    Inherits="FreeProperty.Views.Passport.SearchPassportProvider" %>

<form id="frmContent" runat="server">
<h2>
    Provider Directory</h2>
<div id="MainContainer">
    <asp:hiddenfield id="hdnMode" runat="server" />
    <div>
        <br />
        <b>Search Instructions:</b> At least one of the following search criteria must be
        selected: zip code search, county search or additional search criteria.</div>
    <%--<a target="_blank" href="#">View Data Explanation and Source Information</a>--%>
    <br />
    <div>
        <span class="span">Zip Code Search (optional) </span>
        <div>
            To locate providers within a Zip Code, enter the Zip Code below and select the desired
            distance.</div>
        <br />
        <div>
            <label>
                ZipCode</label>
            <input type="text" runat="server" id="tbZipCode" />
        </div>
        <div>
            <label>
                Distance(miles)</label>
            <asp:dropdownlist id="ddlDistance" runat="server">               
                </asp:dropdownlist>
        </div>
    </div>
    <div>
        <span class="span">County Search (optional) </span>
        <div>
            To locate providers within a particular county, please select from the list below.</div>
        <br />
        <div>
            <label>
                County</label>
            <asp:dropdownlist id="ddlCounty" runat="server">               
                </asp:dropdownlist>
        </div>
    </div>
    <div>
        <span class="span">Select Additional Provider Search Criteria (optional) </span>
        <div>
            Select one or more of the following criteria to refine your search.</div>
        <br />
        <div>
            <div>
                <label>
                    Provider Last Name</label>
                <input type="text" runat="server" id="tbLastName" />
            </div>
            <div>
                <label>
                    Provider First Name</label>
                <input type="text" runat="server" id="tbFirstName" />
            </div>
            <div>
                <label>
                    Office Name</label>
                <input type="text" runat="server" id="tbOfficeName" />
            </div>
            <div>
                <label>
                    Speciality</label>
                <asp:dropdownlist id="ddlSpeciality" runat="server">               
                </asp:dropdownlist>
            </div>
            <div>
                <label>
                    Language(Other than English)</label>
                <asp:dropdownlist id="ddlLanguage" runat="server">               
                </asp:dropdownlist>
            </div>
            </br>
            <div>
                <label>
                    Board Certified</label>
                <input type="checkbox" runat="server" id="cbCertified" class="checkbox" />
            </div>
            <div>
                <label>
                    Accepting New Patients</label>
                <input type="checkbox" runat="server" id="cbAcceptingNewPatients" class="checkbox" />
            </div>
            <div>
                <label>
                    Gender</label>
                <input type="radio" runat="server" name="Gender" id="rbFemale" class="radio" />Female
                <input type="radio" runat="server" name="Gender" id="rbMale" class="radio" />Male
                <input type="radio" runat="server" name="Gender" id="rbNone" class="radio" />No
                Preference
            </div>
        </div>
        <div>
            <span class="span">Search for Providers </span>
            <asp:label id="lblError" cssclass="error" runat="server"></asp:label>
            <div class="error_message">
            </div>
            <input type="button" class="button" value="Search" onclick="javascript:return ValidateSearch('Views/ProviderDirectory/SearchPassportProvider.aspx')" />
        </div>
    </div>
</div>
</form>
<script type="text/javascript">
    $().ready(function () {
        $("#tbZipCode").autocomplete("Views/ProviderDirectory/ZipCodeSuggest.ashx");

    });

    $().ready(function () {
        $("#tbOfficeName").autocomplete("Views/ProviderDirectory/OfficeSuggest.ashx");

    });

    
</script>
